Young women who are attracted to both sexes or who are unsure about who they are attracted to are more likely to develop an eating disorder than those attracted to only one sex, according to a new study from Drexel University.

However, the results of the study suggest that females attracted to the same-sex are no more likely to experience disordered eating symptoms than their peers with opposite-sex attractions. This finding is contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females.

“The results of this study suggests there may be notable differences in disordered eating symptoms across LGBQ persons,” said lead author Annie Shearer, outcomes research assistant for Drexel University’s Center for Family Intervention Science in the College of Nursing and Health Professions. “Given the severe physical and emotional repercussions of eating disorders, these findings underscore the need for primary care physicians to ask about both sexuality and disordered eating symptoms during routine visits.”

The study also found that males who were attracted to other males or both sexes had higher rates of eating disorders than males only attracted to the opposite sex, which is supported by previous research.

“While there is a lot of research indicating gay and bisexual men exhibit higher rates of eating disorders than heterosexual men, findings have been mixed with respect to women,” said Shearer. “Moreover, bisexual and – to an even greater degree – questioning persons are often excluded from these studies.”

The study, “The Relationship between Disordered Eating and Sexuality amongst Adolescents and Young Adults,” is available online here and will appear in a forthcoming print issue of Eating Behaviors, an international peer-reviewed scientific journal publishing human research on the etiology, prevention and treatment of obesity, binge eating and eating disorders in adults and children.

In order to examine disordered eating symptoms and sexuality in adolescents and young adults, the researchers recruited participants from ten primary care sites in Pennsylvania and administered a Behavioral Health Screen – a web-based screening tool that assesses psychiatric symptoms and risk behaviors – during a routine visit. More than 2,000 youths, ages 14-24, were surveyed.

Participants’ eating behaviors were assessed through questions such as, how often do you think that you are fat even though some people say that you are skinny? How often do you try to control your weight by skipping meals? And, how often do you try to control your weight by making yourself throw up?

Sexual attraction was computed based on participants’ gender and to which sex participants reported they felt most attracted to: either males, females, both or not sure. In order to define sexual behavior, participants were asked whom they had engaged in sexual activities: males, females or both.

As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females.

Amongst females, there were no significant differences in disordered eating scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex.

More surprisingly, according to the researchers, females who were unsure of who they were attracted to reported the highest disordered eating symptoms scores of all.

“This study highlights the need to increase sensitivity to the unique needs of sexual minority youth as a group and for the particularly sub groups in that population,” said Guy S. Diamond, PhD, associate professor in the College of Nursing and Health Professions, director of the Couple and Family Therapy Doctoral Program and director of the Center for Family Intervention Science, who co-authored the study. “But it also demonstrates the value of standardized, comprehensive screening for mental health concerns in primary care.”